Date of Doctor of Nursing Practice Project Completion

Spring 6-2023

Faculty Advisor

Debbie McCrea

Abstract

Purpose

The purpose of this project was to implement a nurse-driven hydration protocol to potentially decrease the risk of acute kidney injuries (AKI) in patients undergoing contrast procedures, which in turn should reduce length of stay.

Background

The project was implemented in a CVICU and Cardiac Catheterization Lab (CCL) Lab in an academic center in Houston, Texas.

Methodology

The project utilized Lean Six Sigma methodology and SBAR communication among staff utilizing a nurse-driven protocol to ensure hydration orders were activated during pre- and post- procedure. The staff were educated on how to implement the protocol prior to the start of the project and cyclically during the project. A total of 38 patient intake and output (I&O’s) and creatinine levels were reviewed from the electronic medical record (EMR) to assess baseline changes for AKI development. Nursing staff completed a pre- and post- intervention survey to evaluate changes in knowledge.

Results

After implementing the protocol for 12 weeks, there was a decrease of 6% in AKI’s among the hospital. Nursing staff compliance was 98% and knowledge increased 29%. Findings suggest proper communication and education regarding patient hydration status can reduce the risk of AKIs.

Implications

Findings from this project can be used in other units that utilize contrast and can potentially lead to better outcomes by decreasing risk of AKI’s and decreasing length of stay which would improve patient satisfaction. Sustainability of this project is contingent on continual education.

Keywords

AKI, contrast induced AKI, hydration protocol, acute kidney injury

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